Mode of Action of a Topical Steroid on Immediate Phase Reaction After Antigen Challenge and Nonspecific Nasal Hyperreactivity in Nasal Allergy

Abstract

This study compared the effects of 2-week administration of a topical steroid (fluticasone propionate [FP] 100 μg twice daily) with placebo in 28 patients with perennial nasal allergy who were allergic to house dust and mites in a double-blind randomized study. The number of inflammatory cells and decidual epithelial cells and concentrations of tryptase and eosinophil cationic protein in nasal lavages, and reactivity of the nasal mucosa to histamine and to antigen were investigated. The topical steroid, FP, significantly inhibited all of these assessments. The degree of improvement of nasal reactivity to histamine significantly correlated with the degree of decrease in eosinophil cationic protein levels.

Circadian Variation in Nasal Reactivity in Children with Allergic Rhinitis: Correlation with the Activity of Eosinophils and Basophilic Cells

“…Nasal reactivity in allergic rhinitis is closely related to allergic inflammation, particularly to infiltration by activated eosinophils and basophilic cells in the nasal mucosa [9, 10]. Repeated antigenic challenges in subjects with allergic rhinitis enhance the infiltration of these inflammatory cells in the nasal mucosa and enhance nasal reactivity [11].…”

Effects of cyclosporin A and glucocorticosteroids on antigen-induced hypersensitivity to histamine in a guinea pig model of allergic rhinitis

“…This finding is in contrast to human perennial allergic rhinitis, where topical steroid therapy inhibits nasal reactivity to histamine significantly [13]. The difference in the effects of glucocorticosteroids between these species may be due to difference in application routes, duration of treatment or sensitivity to glucocorticosteroids.…”

“…CyA [10] inhibits transcription of signals from T-cell antigen receptor to cytokine genes [11], is used for inhibiting organ transplant rejective reaction [10] and it has been recently noted that CyA is effective for some patients with chronic severe asthma [12]. Moreover, it has been noted that glucocorticosteroid decreases non-specific nasal hyperreactivity in subjects with allergic rhinitis [13]. Although glucocorticoid has an anti-inflammatory effect [14], it also inhibits cells expressing cytokine mRNA for interleukin-4 (IL4) in the nasal mucosa from patients with allergic rhinitis [15].…”

Intranasal Steroids in the Treatment of Allergy-Induced Rhinorrhea

“…INS have been associated with reduced expression of histamine, a number of cytokines, and other inflammatory mediators produced and/or released by mast cells and basophils during the inflammatory cascade, as well as reduced expression of several proinflammatory cells involved in the pathogenesis of AR (lymphocytes, eosinophils, basophils, mast cells, Langerhans cells, and epithelial cells) (Table 3) [29,[34][35][36][37][38][39][40][41][42].…”

“…Fluticasone propionate also has been reported to reduce eosinophil and basophil counts, ECP levels in nasal lavage, and the number of sneezes after antigen challenge, as well as to reduce nasal mucosa reactivity to histamine [37].…”